PERFORMANCE EVALUATION OF NUCLEATED RED BLOOD CELL (NRBC) COUNT USING A FULLY AUTOMATED HAEMATOLOGY ANALYZER VERSUS MANUAL COUNTING

Nucleated Red Blood Cell Count

  • Tanweer Ahmed Armed Forces Institute of Pathology/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Asad Mahmood Armed Forces Institute of Pathology/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Nasir Uddin Combined Military Hospital Lahore/National University of Medical Sciences (NUMS) Pakistan
  • Helen Mary Robert Armed Forces Institute of Pathology/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
  • Muhammad Ashraf Hazrat Bari Imam Sarkar (HBS) Medical and Dental College, Islamabad Pakistan
  • Usman Tahir Swati Armed Forces Institute of Pathology/National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Keywords: Nucleated RBC Count, Automated haematology analyzer, Bland-Altman Plot, Manual NRBC count

Abstract

Objective: To evaluate the performance of Nucleated RBC (NRBC) Count using a fully automated haematology analyzer versus manual counting.

Study Design: Cross-Sectional Study.

Place and Duration of Study: Department of Hematology, Armed Forces Institute of Pathology, from Sep 2019-Jun 2020.

Methodology: Routine fresh whole blood samples were run on Sysmex XN-3000 automated haematology analyzer and 384 samples with results of ≥0.1% Nucleated red blood cells were included in this study. Manual NRBC counting was carried out twice on Leishman-stained peripheral blood smears from all 384 samples. Comparison between manual and automated nucleated red blood cell counting methods was statistically analyzed through linear regression analysis & coefficient correlation. The degree of agreement between two methods was analyzed through Bland-Altman plot. Finally, concordance between the two methods was also analyzed at 5 different ranges of nucleated red blood cells.

Results: Linear regression analysis revealed a (r2) value of 0.97. Regression equation was calculated as XN = 0.76MC ± 1.28, with 95% limits of agreement between ± 40.42% and -24.47%. A mean bias of 7.97% was demonstrated through Bland-Altman plot. Concordance analysis revealed a concordance rate of 93.74% (360/384). Nucleated red blood cell counting between two methods were more concordant when nucleated red blood cell counts were <200%.

Conclusion: Nucleated red blood cells counting by XN-3000 automated hematology analyzer is statistically comparable to manual nucleated red blood cell counting. We suggest that automated counting can be adopted in routine hematology laboratory as a replacement of manual NRBC counting.

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Author Biographies

Helen Mary Robert, Armed Forces Institute of Pathology/National University of Medical Sciences (NUMS) Rawalpindi Pakistan

Intellectual contribution to analysis, literature review & manuscript preparation

Muhammad Ashraf, Hazrat Bari Imam Sarkar (HBS) Medical and Dental College, Islamabad Pakistan

Intellectual contribution to analysis, literature review & manuscript preparation

Usman Tahir Swati, Armed Forces Institute of Pathology/National University of Medical Sciences (NUMS) Rawalpindi Pakistan

Manuscript preparation & data analysis

Published
2021-10-31
How to Cite
Ahmed, T., Mahmood, A., Uddin, N., Robert, H., Ashraf, M., & Swati, U. (2021). PERFORMANCE EVALUATION OF NUCLEATED RED BLOOD CELL (NRBC) COUNT USING A FULLY AUTOMATED HAEMATOLOGY ANALYZER VERSUS MANUAL COUNTING. PAFMJ, 71(5), 1806-10. https://doi.org/10.51253/pafmj.v71i5.5706
Section
Original Articles

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